Results of treatment of patients with necrotic acute pancreatitis taking into account a risk of an unfavorable course of the disease are analyzed. The risk is determined according to the level of albumin measured with fluorescent test. This approach to choice of policy of treatment which doesn't correspond to clinical picture and treatment may be regarded as preventive permits to improve results of treatment in all variants of the disease. Decreased number of severe complications, lethality and time of hospitalization in necrotic pancreatitis an demonstrated.